Frequently Asked Questions – Here are some common questions that you might ask if you had an insurance claim and were considering legal assistance with your claim.
1.What if I have a claim?
Report your claim immediately Or As Soon As You Discover it: Do not delay in reporting your claim for loss or damage to your insurance company and/or insurance agent. Tell the insurer or agent that you want written confirmation of the claim. There are times that the insurer may claim that it never received notice so document your call and if you can, send an e-mail, fax, or other type of traceable communication to the insurer or agent. You do not want to be in a position where the insurer states that you failed to provide timely notice.
Try to Have Your Insurance Policy In Hand: When you report the claim by e-mail, phone or in person, ask for a copy of your policy to be e-mailed, mailed or scanned to you immediately. Many people only get a new “declarations sheet” and policy endorsements every year but believe that is their whole policy. Insurers seldom send you a new complete policy every year. If you don’t have a complete copy of your insurance policy, the insurance company is required to provide you with a copy at your request. All insurance policies explain your rights, duties, responsibilities and obligations under the policy of insurance and those of the insurance company to you. If you do not have the insurance policy it is difficult for you, and me, to know and understand your responsibilities and the required steps actions you musttake to establish a right of recovery under your policy.
Keep All the Paper and Write It Down. Retain a copy of any and every document you receive from your insurer, your agent, the insurance company adjuster, or even your mortgage lender. This includes all documents of any type that you receive and keep a copy of anything that you send the insurer or anyone else regarding the loss. Be sure to take notes of every telephone conference or personal meeting with an insurance adjuster, agent, investigator or anyone asking you questions regarding your loss. If possible, confirm every meeting in writing with that person as to what was decided and what the next step is to be. Always keep a log of the calls you make, the content of the conversation, and if you left a message of if the phone just rang and rang. The fact that the adjuster did not pick up the phone can be just as valuable to show that the insurer was not looking out for your best interests. Keep all the documents and your notes in one place even if that place is away from your home if that is necessary to keep the information dry and secure. You always spend money out of pocket due to a loss so if you have expenses like buying additional or replacement food or toiletries, renting a place to stay for a night or longer, buying additional clothes because of the loss, or supplies to make temporary repairs or to protect the property keep the receipts in order to recover those covered expenses.
Photos, Photos, Photos. There is a reason there is a saying that “A picture tells a thousand words.” The more photos the better. If there has been a loss to your personal property, home, business or you have experienced a physical injury, take as many photos as possible of the affected property or area that has been injured. Once you find yourself describing the damage or loss instead of saying “Look at the picture” you will realize the value of the photo. Even the most explicit description of the loss or its effect on you really is lost to a third party hearing the description. Sometimes a description understates a picture and what you want is the most effective and descriptive means possible to tell that adjusters, agents, juror and even me what happened, the damage and its effect on you. If the property can be repaired, you should take photographs of each step in the process from the initial demolition to the reconstruction. A picture at the beginning and after repair shows little of the time and attention required to put the property back to its pre-loss condition.
Early settlement offers: Insurance adjusters will often come to the loss site and may want to make a settlement offer based on usually nothing more than a visual inspection Any offer made under those circumstances is incomplete and will not include the full scope of what will be necessary when the job is actually performed. Before you consider any such settlement offer require that the adjuster provide you a written estimate for the repair or replacement of the damaged property and what coverage the offer is being paid under. Your insurance policy often has different coverage sections that may make up the offer and some parts of the policy pay less than others. If you wanted to buy a used car or boat, you would want to do a full inspection before making an offer. Your insurer should do the same for you before making an offer to you. While money in hand right away may seem like the insurer is looking out for you, the insurer knows what the costs of rebuilding is generally better than you so be cautious when money is offered upon the first look at the loss. While the adjuster may seem like he or she is friendly and looking out for you, the adjuster’s first loyalty is to its employer, which is the insurer, and not you. The adjuster gets paid by the insurance company and is not inclined to bite the hand that feeds him or her.
Settlement Checks: When you do receive a check from the insurer, assuming that your claim has not been denied first, be sure to consider the wording on the front of the check, the back of the check, or the letter that may come with the check. There are certain words that have special legal significance that might allow the insurer to claim that you are not entitled to any further payment if you cash that check. If the check has wording about “full and final payment” or if there is some suggestion that the payment is made based on a release of any future or supplemental claims then consider carefully the check and any documents that came with the check. If you endorse and deposit a check such as that described and if you are unclear as to its legal effect, call us before you sign and deposit that check or send it off to the mortgage company. Even if you innocently overlook or misread the language on the check or the documents, your endorsement and depositing of that check may prevent you from further recovery. Even if the adjuster or the representative from the insurer tells you to disregard that language or tells you that all the checks have the same language on it, the legal effect may be the same and prevent you from supplementing the claim. If you release your insurer they will not owe you any further money for your claim even if you find additional damage or even under another coverage in your policy that might pay you more money for your loss. It is always you right to consult with an attorney before signing any document or accepting any payment. If the insurance adjuster says you do not need a lawyer, chances are you definitely need a lawyer. If you feel that the insurer’s damage estimate and settlement offer is too low, you are under no obligation to accept the offer.
It Is Okay To Need Help. Major losses cause major problems and can be more than you may want to handle on your own. If the loss is to your home or business then that can further complicate your loss and the problems that arise. The reporting of the claim is but the first step which will undoubtedly result in requests for the information we discussed above which include may even include a sworn statement which is like a deposition. All insurance policies have a “cooperation clause” which requires you to assist the insurer because that is a right the insurer has under the policy to make you help it with your claim. You are not required to go this alone. Talk with an experienced insurance lawyer. If the insurance company stonewalls your questions or claim, will not pay fair value for your loss, states that your claim is not covered, or denies your claim for damages, talk with an insurance lawyer.
Hire an Insurance Attorney: There are many lawyers in Florida but not many who deal exclusively with insurance claims. Many lawyers find interpreting an insurance policy to be extremely difficult and frustrating. Mr. Kennon has over 18 years of experience in the insurance industry. He has previously represented insurance companies, so he is familiar with their coverage decisions, strategies and tactics. He knows that there are only so many experienced insurance lawyers who represent policyholders like you. He knows that the insurance industry has thousands of lawyers ready to assist it for any dispute that might arise. Most attorneys are not well versed in what is required to take on an insurance company in a coverage dispute. Most lawyers do not understand statutory first party bad faith, which is what governs your claim, or how to preserve that claim for you. Given the complexities of the insurance policies, Mr. Kennon receives clients referred to him by other lawyers who realize that special knowledge is needed for these types of cases. We litigate for you on a contingent fee basis so if we do not win g for you, I work for free.
Consider Your Words Carefully And Always Tell The Truth. When looking to buy insurance coverage or if you are making a claim, even an innocent mistake or material misstatement, innocent or not, on the application or claim form or during the recorded statement taken by the insurer after a claim is made, can result in the insurer voiding your policy as if it never existed or denying your claim. Always tell the truth to your insurer. The insurers may refer your claim if it believes that fraud was involved to law enforcement so be careful in the words you use and be truthful.
2.When do I need a lawyer?
It is recommended that you consult with an insurance lawyer if your insurance company:
Denies that insurance coverage even exists;
Denies your claim because your claim is excluded or partially excluded under your policy;
Denies any part of your claim;
Unreasonably delays the processing, adjustment, or payment of your claim;
Makes misleading or false statements to you;
Refuses to pay you under one coverage or attempts to force you to settle under other policy coverage;
Tries to lowball you with undervalued estimates, offer or payments;
Tells you that you do not need a lawyer to resolve the claim;
Requires a written release of any supplemental claim as a condition of settlement or payment on your claim;
The check for payment from your insurer or the letter that accompanies it uses terms like “full” or “final” when you reasonably believe that you have a supplemental or additional claim for that loss.
Hans Kennon Attorney
20 N. Orange Ave.
Orlando, FL 32801